■这项研究是为了评估视敏度(VA),并发症,通过平坦部玻璃体切除术(PPV)治疗的息肉状脉络膜血管病变(PCV)和视网膜动脉大动脉瘤(RAM)诊断为黄斑下出血(SMH)的患者的预后,视网膜下组织纤溶酶原激活物(tPA),玻璃体腔内空气填塞。它有助于开发可广泛用于改善视力和治疗SMH患者潜在并发症的通用治疗方法,不管潜在的病理生理状况,如PCV或RAM。
■在这项回顾性研究中,根据诊断将SMH患者分为两组:(1)息肉状脉络膜血管病变(PCV)和(2)视网膜大动脉瘤(RAM)。分析PPV+tPA(视网膜下)手术后PCV和RAM患者的视力恢复情况及并发症发生情况。
■共纳入36例患者的36只眼:PCV(47.22%,17/36)和RAM(52.78%,19/36)。病人的平均年龄是64岁,63.89%(23/36)的患者为女性。术前VA中位数为1.85logMAR,手术后1个月和3个月为0.93和0.98logMAR,分别,表明大多数患者术后视力得到改善。术后1、3个月随访,每位患者在术后1个月和3个月被诊断为孔源性视网膜脱离,4例患者术后3个月出现玻璃体出血。术前,患者出现黄斑视网膜下出血,视网膜隆起,还有血块周围的渗出.术后,大多数患者表现为视网膜下出血的分散。光学相干断层扫描结果显示,术前视网膜出血涉及黄斑和中央凹下方神经上皮和色素上皮下方的出血性凸起。手术后,注入玻璃体腔的空气被完全吸收,视网膜下出血被分散。
■PPV结合视网膜下注射tPA和玻璃体腔内空气填塞,可促进由于PCV和RAM而患有SMH的患者的适度视力恢复。然而,可能会出现一些并发症,他们的管理仍然具有挑战性。
UNASSIGNED: This study was carried out to evaluate the visual acuity (VA), complications, and prognosis of patients diagnosed with submacular hemorrhage (SMH) from polypoidal choroidal vasculopathy (PCV) and retinal arterial macroaneurysm (RAM) treated by pars plana vitrectomy (PPV), subretinal tissue plasminogen activator (tPA), and air tamponade in vitreous cavity. It facilitates the development of generic treatment methods that can be widely used to improve vision and treat potential complications in patients with SMH, regardless of the underlying pathophysiological condition, such as PCV or RAM.
UNASSIGNED: In this retrospective study, SMH patients were divided into two groups based on their diagnosis: (1) polypoidal choroidal vasculopathy (PCV) and (2) retinal arterial macroaneurysm (RAM). The visual recovery and complications of patients with PCV and RAM after PPV + tPA (subretinal) surgery were analyzed.
UNASSIGNED: A total of 36 eyes of 36 patients were included: PCV (47.22%, 17/36) and RAM (52.78%, 19/36). The mean age of the patients was 64 years, and 63.89% of the patients (23/36) were female. The median VA was 1.85 logMAR before surgery, 0.93 and 0.98 logMAR at 1 and 3 months after surgery, respectively, indicating that most patients\' vision improved after surgery. At the 1 and 3 months postoperative follow-up, each patient was diagnosed with rhegmatogenous retinal detachment at 1 month and 3 months postoperatively, and four patients had vitreous hemorrhage at 3 months postoperatively. Preoperatively, patients exhibited macular subretinal hemorrhage, retinal bulge, and exudation around the blood clot. Postoperatively, most patients showed dispersal of subretinal hemorrhage. Optical coherence tomography results revealed retinal hemorrhage involving the macula and hemorrhagic bulges under both the neuroepithelium and the pigment epithelium under the fovea preoperatively. After surgery, the air injected into the vitreous cavity was completely absorbed and the subretinal hemorrhage was dispersed.
UNASSIGNED: PPV combined with subretinal tPA injection and air tamponade in the vitreous cavity can facilitate modest visual recovery in patients with SMH due to PCV and RAM. However, some complications may occur, and their management remains challenging.